https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=8218

Atazanavir / ritonavir

Lamotrigine

Dosage adjustment may be necessary.

No pharmaceutical opinion available for this interaction.

Mechanism

Atazanavir / ritonavir can induce the metabolism (UGT 1A4) and decrease the concentration of Lamotrigine.

Atazanavir / ritonavir

Pharmacodynamic effects

–

Recommendations

–

Alternative solution(s)

–

Lamotrigine

Pharmacodynamic effects

Possible decrease of clinical efficacy.

Recommendations

An increase in dosage may be necessary.

Monitor for signs and symptoms of therapeutic failure.

Alternative solution(s)

–

Monitor

–

Tests

Lamotrigine

Pharmacokinetic parameters
Parameters
Reference number
# patients
HIV
Dose
Frequency
AUC
Cmax
Lamotrigine
2221
17
-
100 mg
x 1
- 32%
- 6%
Atazanavir / ritonavir
2221
17
-
300/100 mg
QD
 
 
Comment

A lamotrigine dose of 200 mg BID with PI produces a concentration similar to lamotrigine 100 mg BID used alone.

See also lopinavir/ritonavir + lamotrigine.

Comment
Reference
  • 122
    Ritonavir (Norvir), Corporation AbbVie, Quebec, Canada, 5 juillet 2021.
  • 2111
    Van der Lee MJ, Dawood L, ter Hofstede H, et al. Lopinavir/ritonavir reduces lamotrigine plasma concentrations in healthy subjects. Clin Pharmacol Ther 2006; 80:159-168.
  • 2219
    Sandson N. An overview of Psychotropic Drug-Drug Interactions. Psychosomatics 2005;46(5) : 464-489.
  • 2221
    Burger D, Huisman A, Van Ewijk N, Neisingh H, Van Uden P, Rongen G, Koopmans P, Bertz R. The Effect of Atazanavir and Atazanavir/Ritonavir on UDP-Glucuronosyltransferase Using Lamotrigine as a Phenotypic Probe. Clin Pharmacol Ther. 2008.
  • 1382
    Atazanavir (Reyataz), Bristol-Myers Squibb, Quebec, Canada, 26 octobre 2018.